Dynamic conformal arc radiotherapy with rectum hollow-out technique for localized prostate cancer.
OBJECTIVE
To report the feasibility of dynamic conformal arc radiotherapy with rectum hollow-out technique (DCAT-HO) for localized prostate cancer.


METHODS
Between October 2000 and April 2007, 204 patients with clinically localized or locally advanced prostate cancer were treated with DCAT-HO. All patients were given neoadjuvant total androgen deprivation (AD) therapy (median 6 months, range 2-27 months). All patients with T3 or T4 stage received post-irradiation AD for 24 months. A total of 128 patients (63%) were treated with 70Gy, and 76 patients (37%) were treated with 74Gy. Acute and late toxicities were scored by the Radiation Therapy Oncology Group morbidity grading scales. PSA relapse was defined as three successive PSA elevations after a post-treatment nadir. The median follow-up was 37 months.


RESULTS
Both the acute Grade 2 rectal and urinary toxicities were 1.0%, and no patients experienced acute Grade 3 or higher symptoms. The 3-year rates of both late Grade 2 rectal and urinary toxicities were 3.4%. The 3-year PSA relapse-free survival for low, intermediate, and high-risk group patients treated with 70 Gy were 54%, 75%, and 87%, respectively.


CONCLUSIONS
These findings demonstrate the feasibility of DCAT-HO in a large number of patients with short follow-up. DCAT-HO reduced the volume of the rectum exposed to higher doses and this led to an overall reduction in late rectal toxicity.
Tomita
Natsuo
N
Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan. ntomita@aichi-cc.jp
Kodaira
Takeshi
T
Tachibana
Hiroyuki
H
Nakamura
Tatsuya
T
Tomoda
Takuya
T
Nakahara
Rie
R
Inokuchi
Haruo
H
Hayashi
Norio
N
Fuwa
Nobukazu
N
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012007:Rectum / Q000528:radiation effects; D001743:Urinary Bladder / Q000528:radiation effects
D000726:Androgen Antagonists